Percutaneous femoroplasty for the treatment of proximal femoral metastases

Abstract

Purpose: To investigate the clinical value of percutaneous perfusion of bone cement as a treatment for proximal femoral metastases.

Methods: Twenty-one patients with 23 lesion sites of proximal femoral metastases were treated using percutaneous femoroplasty (PFP) and followed up for 6-12 months. Patient responses to the Verbal Rating Scale pain classification scheme were used to assess the degree of pain relief after 2 days and again after 6 months. The Barthel Index of Activities of Daily Living (BIADL) was used to assess the patients' quality of life after 6 months.

Results: PFP effectively reduced the levels of pain in all 21 patients. Two patients experienced cement leakage into the hip during the operation, whereupon the cement injection was stopped immediately. One patient experienced irritating pain during the operation caused by the bone cement injection, and the pain was alleviated immediately upon stopping the injection. None of the patients experienced pulmonary embolism or complications of proximal femur pathological fractures during the study period. The pain relief efficiencies of PFP at 2 days and 6 months postoperation were 90% and 84%, respectively. The patient scores on the Barthel Index of Activities of Daily Living 6 months postoperation were significantly improved compared to preoperative scores (P < 0.05).

Conclusions: PFP is an effective and minimally invasive treatment for proximal femoral metastases that can significantly improve the patient's quality of life. However, the proposed indications should be strictly followed.

Keywords: Femur; Metastasis; Pain relief; Percutaneous femoroplasty; Quality of life.